EVENING. Health.

A Drug To Fight Drugs

March 22, 1994|By Sandra Blakeslee, New York Times News Service.

Driven by a deep sense of frustration that efforts to cure drug addiction are going nowhere, federal researchers are testing a bizarre, mind- altering drug called ibogaine as a possible new treatment for cocaine and heroin addiction.

The drug, drawn from the roots of a West African shrub, has been tried on only 60 people. But several doctors and patients say the compound works wonders, often banishing symptoms of withdrawal and craving for months if not years. Intrigued and at the same time skeptical, researchers have decided to see if the drug works as well as its supporters claim.

Their work with ibogaine has opened the door to a new theory of how the brain becomes addicted to substances such as heroin, cocaine, nicotine and alcohol.

The theory, which runs counter to current models of drug dependency, suggests that addiction is rooted in the cerebellum, the area of the brain where the connections for motor coordination, memory and dreams meet, and that it involves the same kind of ingrained conditioning that makes it possible for young children to learn to walk.

Ibogaine advocates claim that a single dose of ibogaine taps into this critical brain circuit and banishes withdrawal symptoms and drug cravings, sometimes for extensive periods.

But scientists who are familiar with the drug urge caution. "At this point, there is no credible scientific evidence that ibogaine cures addiction," said Dr. Herbert Kleber, a psychiatrist and director of the division of substance abuse at Columbia University College of Physicians and Surgeons in New York. "All the evidence is anecdotal and not based on carefully controlled scientific studies."

Nevertheless, since every effort to find a cure for cocaine addiction has so far failed, "it is appropriate to look at any promising agent to see if it works," Kleber said. "It would be foolish to rule anything out."

And, indeed, driven by this sense of frustration and a congressional mandate to seek effective treatments for drug abuse, federal researchers are taking a close look at ibogaine. In the last year the National Institute of Drug Abuse has sponsored 18 animal studies on the compound. And last August, the Food and Drug Administration decided to let researchers begin limited testing of the drug in humans.

"The FDA recognizes drug-abuse disorders as being lethal disorders with no good current therapy," said Dr. Curtis Wright, a medical officer at the agency. "Right now we don't have any other candidate drug that looks as good as ibogaine. At least we have a group of patients and doctors who say this stuff works."

Used in pubertal initiation rites in Gabon, ibogaine induces a powerful altered state for at least 48 hours, during which young people are said to come into contact with a universal ancestor called Bwiti.

In 1962, when psychedelic drugs were newly popular in the U.S., a group of 20 recreational drug users, including a young heroin addict named Howard Lotsof, heard about the drug and decided to try it. Of the seven who were heroin addicts, five, including Lotsof, claimed that taking the drug extinguished, at least temporarily, their desire for heroin. The other two, in spite of similar feelings, decided to go on using heroin anyway, Lotsof said, because they were Beat Generation poets and they said they liked being junkies.

"For ibogaine to work," Lotsof said, "you have to not want to continue on drugs. Some people don't want to kick their habit and ibogaine cannot help them."

When the AIDS epidemic began claiming the lives of thousands of drug addicts, Lotsof's continuing interest in ibogaine grew into a crusade.

In the mid-1980s, he persuaded a Belgian company to manufacture ibogaine in capsule form and begin offering it to addicts in the Netherlands, where drug policies are lenient. Like LSD, mescaline and many other drugs, ibogaine is illegal in the United States.

Of the 60 people who have been treated thus far, 50 were recruited by an addict self-help group in the Netherlands, Lotsof said. "These were people who had failed all other treatments and had completely hit bottom," he said. Very little information exists about the long-term effect of the drug, but at least three remained free of drugs for several years.

"We anticipate that many of the 50 volunteers fell back into drug use," Lotsof said, "but we have no way of tracking them."